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Heartbeat is considered the rhythm of life and when there's a problem with that rhythm, pacemaker implantation may be the solution. A pacemaker is a medical device implanted to regulate abnormal heart rhythms, particularly in patients with arrhythmias, where the heart either beats too slowly or irregularly. This small device helps maintain a regular heartbeat by sending electrical impulses to the heart. With advancements in medical technology, permanent pacemaker implantation has become a routine procedure, offering numerous benefits to patients with cardiac rhythm disorders. In this blog, we will explore the procedure, different types of pacemaker implantation and their associated benefits. Continue reading till the end and find out what our expert heart specialist in Patiala has to share about permanent pacemaker implantation.
Synopsis
Procedure for Pacemaker Implantation
Pacemaker implantation is generally performed under local anaesthesia, however, sedation may be used for patient comfort. The procedure consists of 3 phases and is relatively quick.
1. Preoperative Preparation: In the preoperative phase, the patient undergoes various tests like electrocardiograms (ECG), echocardiograms, or stress tests to determine the specific nature of their heart condition. They are also advised to stop certain medications, such as anticoagulants, to reduce the risk of bleeding during surgery.
2. Implantation Procedure: In the operative phase a small incision is made near the shoulder, usually on the left side. The pacemaker leads (wires) are then threaded through a vein into the heart, guided by X-ray imaging. Once the leads are positioned correctly, the generator is placed under the skin, just beneath the collarbone. The leads are connected to the generator, which is programmed to suit the patient’s specific pacing needs and the incision is stitched back up.
3. Postoperative Care: In the postoperative phase the patient is monitored for any signs of complications such as bleeding, infection, or lead dislodgement. Most patients can go back to their homes the day after the procedure. Recovery usually takes a few days to a week, during which patients are advised to avoid strenuous activities and heavy lifting.
Types of Permanent Pacemakers
There are different types of pacemaker devices and implantation techniques, and the choice depends on the specific cardiac issue being treated. Here is the list of major permanent pacemaker types:
1. Single-Chamber Pacemaker
A single-chamber pacemaker has one lead, which is typically placed in either the right atrium or right ventricle of the heart. This type of pacemaker is usually recommended for patients with chronic atrial fibrillation or bradycardia. When the lead is placed in the right atrium, it helps regulate the atrium's rhythm, and when placed in the right ventricle, it ensures that the ventricle contracts properly to pump blood to the body.
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Indications: Primarily for patients with bradycardia or those who have permanent AFib with a slow ventricular response.
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Benefits: It is less invasive, involves fewer risks during implantation, and is suitable for patients who do not require complex pacing needs.
2. Dual-Chamber Pacemaker
A dual-chamber pacemaker has two leads, one in the right atrium and the other one in the right ventricle. This device is used to mimic the natural pacing of the heart, synchronizing the atrial and ventricular contractions. The dual-chamber pacemaker ensures that the atrium contracts to push blood into the ventricle, which then contracts to pump blood out to the body.
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Indications: Recommended for patients with AV block, sinus node dysfunction, or heart block where coordination between atria and ventricles is compromised.
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Benefits: This type offers more natural pacing of the heart and better coordination between atrial and ventricular contractions, improving overall cardiac efficiency and patient quality of life.
3. Biventricular Pacemaker
A biventricular pacemaker is used for patients with heart failure or ventricular dyssynchrony, where the left and right ventricles do not pump in sync. In this case, an additional lead is placed in the left ventricle, allowing the device to stimulate both ventricles simultaneously. This helps improve the efficiency of the heart's pumping action.
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Indications: Recommended for patients with heart failure and reduced ejection fraction typically below 35% who have a prolonged QRS complex on an electrocardiogram.
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Benefits: Biventricular pacing can significantly improve the heart’s ability to pump blood, reduce symptoms of heart failure, improve exercise tolerance, and potentially increase survival rates in certain patients.
4. Leadless Pacemaker
The leadless pacemaker, a more recent advancement in pacemaker technology, is a small capsule-like device that is implanted directly into the heart eliminating the need for leads. The procedure is minimally invasive, usually done via a catheter inserted through the femoral vein in the groin. The leadless pacemaker is typically implanted in the right ventricle.
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Indications: Suitable for patients who need single-chamber pacing, often those with atrial fibrillation and slow heart rates or patients at higher risk for complications from traditional lead-based pacemakers.
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Benefits: The lack of leads eliminates the risk of lead-related complications such as infections or lead fractures. This type of pacemaker is less invasive, offers a shorter recovery time, and reduces the likelihood of certain complications.
Consult our cardiologist in Patiala if you need a permanent cardiac pacemaker to manage your heart condition.
Benefits of Pacemaker Implantation
1. Improved Quality of Life
One of the most significant benefits of pacemaker implantation is the improvement in a patient’s quality of life. Patients with bradycardia or heart block often experience fatigue, dizziness, and shortness of breath. By restoring a normal heart rhythm, pacemakers allow individuals to return to everyday activities without the symptoms that previously limited them.
2. Prevention of Life-Threatening Arrhythmias
Pacemakers can prevent dangerous arrhythmias that could lead to fainting, heart failure, or sudden cardiac death for patients with heart block or sick sinus syndrome. Pacemakers are lifesaving devices, ensuring that the heart continues to beat in a controlled and regular manner.
3. Reduction in Heart Failure Symptoms
In patients with heart failure, particularly those with ventricular dyssynchrony, a biventricular pacemaker can improve the heart's pumping efficiency, alleviating symptoms such as swelling, fatigue, and shortness of breath. This can also enhance exercise capacity and overall physical endurance.
4. Increased Longevity
Pacemakers not only improve day-to-day well-being but also contribute to increased longevity in patients with severe heart rhythm disorders. By improving the heart’s ability to pump blood, and preventing dangerous slow heart rates pacemakers help prevent complications such as stroke, heart failure, and death.
5. Reduced Hospitalizations
Patients with pacemakers often experience fewer hospitalizations for heart-related issues after implantation. Properly functioning pacemakers reduce the risk of heart failure exacerbations, syncope, and arrhythmia-related emergencies, resulting in fewer admissions and reduced healthcare costs.
Consult our cardiology hospital in Patiala if you need permanent pacemaker implantation.
Conclusion
By offering a safe and effective way to control arrhythmias and improve the quality of life for millions of patients worldwide, permanent pacemaker implantation has revolutionized the management of heart rhythm disorders. With advancements in technology and surgical techniques, pacemaker implantation procedures are becoming more refined, offering various options tailored to individual patient needs. Whether through single-chamber, dual-chamber, or biventricular devices, pacemakers provide a critical lifeline for patients with arrhythmias, significantly enhancing both survival and day-to-day functioning.
Book a consultation with our experienced cardiologist in Patiala to discuss your individual problem. We also invite you to explore our blog page to read the latest healthcare blogs shared by our doctors.
FAQ's
How long a permanent pacemaker lasts depends on the specific model of pacemaker and how often it must assist your heart. Pacemakers are now available that can last up to 10 or 15 years.
Several electronic devices can interfere with pacemaker and an individual must avoid devices like cell phones, electronic cigarettes, and headphones. Consult with our expert cardiologist in Patiala for guidance regarding the do’s and don’ts to follow after getting a permanent pacemaker.
This depends on the reason for removal and the dependence of the patient on the pacemaker. Some patients cannot live without a pacemaker so a “temporary pacing wire” has to be inserted through a vein in the groin or the neck before the permanent pacemaker and leads can be removed.
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